CPT code 49083: Paracentesis, with imaging guidance2026 Medicare rate & RVUs

Medicare pays $284.24 for 49083 nationally in the office and $92.85 in a hospital or facility. Local office rates run $250.93–$381.90.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 49083 covers

A clinician uses imaging, commonly ultrasound, to guide a needle or catheter into the peritoneal cavity and remove ascitic fluid. The procedure may obtain fluid for diagnostic testing or relieve symptoms from fluid accumulation, such as abdominal distention or discomfort. It is performed in settings including hospitals, outpatient departments, and offices by physicians or other qualified practitioners who perform paracentesis.

Select 49083 when imaging guidance is used; 49082 is the corresponding code for paracentesis without imaging guidance. Documentation should support the indication, fluid removal, and use of imaging to guide the procedure. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 49083 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49083 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 49083 rate is calculated

Each of 49083’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 49083

The CMS indicators that decide how 49083 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49083 compared with similar codes

How to choose

49082ParacentesisWithout imaging guidance

Both codes describe abdominal paracentesis; choose 49083 when imaging guides the procedure and 49082 when it does not.

49084Peritoneal lavageDiagnostic abdominal fluid lavage

49083 removes peritoneal fluid through a needle or catheter. 49084 describes peritoneal lavage rather than routine fluid drainage.

49020Abscess drainageOpen peritoneal approach

49083 is percutaneous fluid removal from the peritoneal cavity. 49020 describes open drainage of an abdominal abscess.

Codes related to 49083

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates